Electronic medical records

While the U.S. health care industry has been on the cutting edge of medical technology, many acknowledge the industry is woefully behind in the use of clinical information technology. While banking and other industries have made tremendous strides in this area, many providers have not had the resources to adopt new ways of dealing with their patients.

Thanks to President Bush, there is renewed interest in developing electronic medical records systems, according to Richard Streck, M.D., senior vice president of medical affairs at the Akron General Medical Center (AGMC.)

“President Bush has called for having all clinical information readily available to health care providers across the country,” he says. “That means having the information stored in an electronic format so it can be quickly transmitted anywhere in the country.”

Smart Business spoke with Streck about the benefits of electronic medical records and how the system is being developed.

How do medical providers access electronic patient data?
Much of this information will be available through the use of secure Internet sites. For example, our AGMC physicians are able to log onto a secure network over the Internet to access patient clinical information, including lab reports and X-ray images.

There’s been a lot of discussion about creating regional health care information Web sites where all of the health care providers in a region will share regional clinical information. This will build upon the separate information networks that hospitals like ours have built, and will link them together with the ultimate vision of linking all of the regional systems together throughout the country and even the world.

How are medical records converted to electronic data?
A lot of clinical information is already stored digitally, including X-ray images and laboratory data. Here at AGMC, we scan entire patient records upon patient discharge, allowing for electronic storage of historical data. The next big step is entering the physicians’ and nurses’ notes into the system. The ultimate goal is to have this information available electronically in real-time.

How are electronic medical records stored?
Typically, the information is stored in a central data repository, which is basically a large computer hard drive where all of the information that’s coming in from different clinical areas is funneled into one storage area on the computer. In essence, it’s a huge relational database. A unique patient identifier allows each of those elements to be linked to one individual patient.

How do medical providers ensure privacy of medical information?
There are multiple layers of security, including the requirement of a password and user ID to access the information. Research is also being done on the use of biometrics such as fingerprint readers or retinal scanners as another form of authentication for accessing clinical information. However, it’s important to remember that there is a security advantage to these electronic systems as they provide the ability to track who accesses records. With electronic records, it’s possible to track how often records are accessed, who is accessing the data, and what data was accessed.

How will patients benefit from electronic medical records?
There are multiple benefits to patients. First, there is an improved efficiency of care. A complaint we often hear from patients is the need to provide the same basic information every time they interact with a different medical department. Electronic systems can capture that information once and pass it along across the system.

More importantly, however, is the ready accessibility to pertinent clinical information when it’s needed. For example, if someone enters an emergency room and is unable to communicate or provide a medical history, the attending physician could have immediate access to important information about medications taken, drug allergies, previous surgeries and other health care issues or problems.

Lastly, these information systems can help us reduce medical errors, including legibility errors when a pharmacist can’t read a physician’s handwriting on a prescription. There’s also artificial intelligence built into these systems that flags the caregiver if there is a potential drug interaction or if the patient has an underlying medical condition that may make prescribing a certain medication problematic.

How will electronic medical records impact health care delivery?
One exciting potential benefit is in the area of disease management. We know from past experience and studies that there are specific steps we can take, including patient education, to help manage specific diseases. By building prompts and reminders into the system, caregivers can be sure they have implemented all of the best components of care for specific diseases.

RICHARD STRECK, M.D., is senior vice president of medical affairs at the Akron General Medical Center. Reach him at (330) 344-6789.